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Radiology Coding Alert

Reader Questions:

Check It Out When in Doubt

Published on Sat Jan 01, 2005

Question: I got a report on an elderly patient regarding an insufficiency fracture of the pelvis. Which diagnosis code should I use?

Minnesota Subscriber Answer: An insufficiency fracture is a type of stress fracture, so generally look to 733.95 (Stress fracture of other bone).
 
Insufficiency fractures often occur in patients with osteoporosis (typically a 733.xx [Osteoporosis] code), so you may be able to report this code, as well, if documentation supports it.
 
You might be tempted to report this as a pathologic fracture (733.1x) because this stress fracture results from normal or physiologic stress on a weakened bone, but technically this is a stress fracture.
 
If you have any doubt at all, ask the physician for a more specific diagnosis.
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